Characteristics and clinical aspects of patients with spinal cord injury undergoing surgery

Abstract

r e v b r a s o r t o p. 2 0 1 7;5 2(4):479-490 SOCIEDADE BRASILEIRA DE ORTOPEDIA E TRAUMATOLOGIA w w w. r b o. o r g. b r a b s t r a c t Objective: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. Methods: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. Results: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cer-vical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery. Individuals undergoing surgery were associated with complications after treatment. The authors assessed whether age influenced the characteristics of patients submitted to surgery. Subjects with <60 years of age were associated with motorcycle accidents and the morphologies of injury were fracture-dislocation. Elderly individuals were associated to fall, SCI in the lower cervical spine and the morphology of injury was listhesis. Subsequently, the authors analyzed the gender characteristics in these patients. Women who suffered car accidents were associated to surgery. Women were associated with paraparesis and the morphologic diagnosis was fracture-explosion, especially in the tho-racolumbar transition and lumbosacral regions. Men who presented traumatic brain injury and thoracic trauma were related to surgery. These individuals had a worse neurological status and were associated to complications. Men and the cervical region were most affected, thereby, these subjects were analyzed separately (n = 92). The presence of complications increased the length of hospital stay. The simultaneous presence of morphological diagnosis , worst neurological status, tetraplegia, sensory, and motor alterations were associated with complications. Pneumonia and chest trauma were associated with mortality. Conclusion: These factors enable investments in prevention, rehabilitation, and treatment.